There was an article online today that caught my attention for a few moments; it was entitled “New Eating Disorders: Are They For Real?” I’m what you would probably call intellectually curious, and having worked for a while in clinical settings, I’m also extra-curious about new medical or psycho-social findings. (J. has often mocked me good-naturedly for my inability to resist the temptation to watch televised documentaries about conjoined twins, strange maladies, medical mysteries, and the like.) Obviously I found it impossible to stop myself from clicking over and reading the article to see what these new disorders were all about.

The two disorders that were highlighted in the article were something called Adult Selective Eating, of which I’d never heard; and Orthorexia, which I’ve read a bit about before. I should say right from the start that I believe fully in the possibility that both of these things are real, serious, psychologically based disorders. While many of the comments following the article made reference to “grown-up spoiled brats” and seemed to eye-rollingly discard the possibility of either of these disorders being worth a moment’s consideration, I’m not in that camp. It seems to me that ANYTHING, when taken to its severe extremes, can become dangerous; this theory proves true in many areas of life, not just in the eating realm. I can certainly see how being a severely restricted eater, while worrisome in children, might end up becoming a life-threatening compulsion in adulthood. I can also see how true orthorexia — obsessive fixation on healthy eating, to the point where it restricts one’s diet and impacts daily functioning — could become as emotionally crippling as any other obsessive-compulsive disorder, left unmanaged. I don’t question the legitimacy of these “new” disorders.

The problem I’m having with the article stems from this quote: “Those affected (by orthorexia) may start by eliminating processed foods, anything with artificial colorings or flavorings as well as foods that have come into contact with pesticides. Beyond that, orthorexics may also shun caffeine, alcohol, sugar, salt, wheat and dairy foods. Some limit themselves to raw foods.”

Um. We’ve eliminated most, if not all, processed foods, and we’re working hard on reducing or eliminating entirely artificial colorings and pesticide exposures. We know many people who don’t take in caffeine or alcohol, and many others who eliminate items like sugar, salt, wheat, and dairy from their diets. Some do almost ALL of these things out of concern for their health or the health of their families; and while I may not agree that it’s all necessary for good health and well-being, I certainly don’t consider any of these people DISORDERED.

Again, let me be clear: It’s not that I think orthorexia doesn’t exist. But, dear article, to borrow a phrase from one of my favorite movies: You keep using that word. I do not think it means what you think it means.

My parents once had an acquaintance who was extremely thin, almost painfully so. They, and many other people they knew, would refer to her behind closed doors as being anorexic. Maybe she was; I don’t know. I’ve thought, though, that she might have been orthorexic, in the true sense of the word. She ate, publicly, but would only eat very specific foods which she seemed to choose for their “healthful” properties. Skinless chicken or turkey, cooked with no butter or oil. Broccoli and other green vegetables, again cooked with no added fats, or eaten raw. She seemed obsessed with whether or not she thought the food was good for her, and clearly, it impacted her life rather severely.

To me, any article or news piece that draws a parallel between that type of behavior and the type of grassroots movement that has grown up around the conscious eating effort is both misguided and somewhat inflammatory. Oh, certainly the author doesn’t mean to inflame anyone; there’s no ill will intended, as far as I can tell. But there is already so much of a divide between the “eating classes” in our society that I’m very aware of any potential to increase the Us vs. Them mentality. Let’s face it: this conscious eating business is often the province of the “haves,” rather than the “have nots,” simply because of our agricultural, commercial, and economic systems; and as far as the public discourse, it’s becoming, to my chagrin, a symbol of so-called “liberal elitism” to be a farmer’s market-shopping, food-dye avoiding, GMO-hating eater.

It shouldn’t be this way. In my mind, wanting the best possible quality in our food supply to nourish our bodies and our childrens’ bodies is not the province of any particular socio-economic class, political affiliation, religious community, or any other “type” of people. Yet, as with any movement towards real, sweeping change, this one has incited deep passions in many people; and as accusations of “Nanny States” and “socialism” and other, uglier sentiments swirl around those of us who follow Pollan, Bittman, Nestle, et al, I can’t help but think that we need more unified and civil discourse, not more reasons to point fingers at one another in scorn and mistrust.

It’s no more a “disorder” to eliminate processed foods and artificial colors than it is to feed yourself or your kids on a steady diet of fast food, Lunchables, neon yogurt tubes, and Twinkies; yet we may choose to pathologize one of these lifestyle choices while vaguely and confusingly muttering about “moderation” in the other. We haven’t got a clue how to talk about these things clearly and with a tone of civility, so we fall back on the old human pattern of vilifying that which we simply don’t understand. And when we do so, we run the risk of not only stalling our own movement towards change; we also dangerously muddy the waters by minimizing the very real challenges that are faced by people who do, legitimately and painfully, struggle with eating disorders of all types.

I know of what I speak. I take this very personally, not because I think there’s intentional misrepresentation going on, but because I believe strongly in shades of gray. Somewhere between conscious eating, orthorexia, and anorexia, there are tipping points. I know all too well where mine are. I hope all my fellow conscious eaters know where theirs are. But before we get to those moments of crisis — long before — we’re striving to get to a place of true balance for ourselves, our health, our children, our environment. Let’s not allow careless reporting to diminish the challenges faced by any of us — those struggling with real eating disorders, and those struggling to illuminate the Great National Eating Disorder that’s consuming us all.

7 Responses to The “New Eating Disorder:” This Time, it’s Personal

I hope I was clear that I believe we’re on the same page with this. My comments are made only to add to the information base of readers unfamiliar with mental health diagnoses so that, hopefully, they can take media zeal with the box of salt it deserves.

My concern is that agribusiness/Monsanto/big pharmacy will use this information as a put-down for all of us who don’t want their chemicals in our food because our bodies weren’t built to handle that stuff. After all, it affects their profits. As a therapist who treats eating disorders, addictions, and other compulsive behaviors, and as a person who wants safe food, I’m also worried about the response of poorly-informed folks to emotionally-loaded name-calling.

This is something I’ve been thinking about and grappling with a lot lately, Linda; the idea that food and eating well are becoming a divisive force in our society rather than a unifying factor behind which everyone can rally. And it was so disheartening to me to read that particular article and all of the comments that followed it. So many people seem to want to reduce this to a personality issue, when it’s not at all; it’s a long-term health and society issue. I was thinking the other day about how, as a kid, I wore a “Save the Rainforests” T-shirt until it had holes in it, and went to volunteer at the food pantry on school vacations just because I thought it was a good idea; those were the “big causes” in my world then, and at the time, the rainforest thing was just coming into “fashion.” Now I’m finding myself on the cusp of another “fashionable” cause that will likely grow into a legitimized worldwide concern given another few years. We just have to weather the criticisms and keep fighting the good fight until then.
Thanks for reading and commenting! Hope to see you back here sometime.

Thanks for your response. I’d like to mention also that the categories of ” orthorexia nervosa” and “adult selective eating disorder” are NOT official diagnostic categories in either the DSM IV-TR (current official diagnostic manual for mental health issues used by therapists, doctors, nurses, etc., and recognized by third party payors such as insurance companies) or the ICD 10 (International Congress on Diseases) manual, recognized and used by health professionals worldwide. As far as I know (and I try to keep up with it), these categories are not being considered for inclusion in future revisions of either manual, and the behaviors described, when problematic, would be diagnosed as an Obsessive-Compulsive Disorder, an Impulse Control Disorder, or other designation for which an individual met diagnostic criteria. Changes in these manuals are researched and debated for years before inclusion in a new edition. It is irresponsibe for the media or anyone else to imply at this time that “orthorexia” is a legitimate diagnostic category. I can only wonder where they got the idea to do that.

I’m in agreement. I think there’s a line, and that line is different for everyone, but it’s tricky when the media decides to shape public opinion of that line and judge those who are making the right choices for the right reasons, rather than the “right” choices for disordered reasons.

Deidre, that’s it exactly. It’s so hard to say what motivates people to make the choices they make, and the last thing I want is for families all over America to start worrying about their loved ones who are simply trying to find a more balanced way of eating based on some misconception of what constitutes an “eating disorder.”